11/20/2021
Preamble
The medical profession has long subscribed to a body of ethical statements developed primarily for the benefit of the patient. Likewise, the American Society of Echocardiography (ASE) recognizes its members have certain ethical obligations to their patients, the profession, each other, the community, and the world at large. As members of the healthcare profession and the ASE, individuals must recognize and respect these obligations.
The ASE Code of Ethics strives to set standards and provide guidance for ASE members acting within the organization, in their clinical practice, and in their provision of health care.
This document sets forth the governing principles, values, and beliefs shared by members of the American Society of Echocardiography, as well as the ethical behavior and standards of conduct
expected in conformance with these principles and beliefs. The society may initiate disciplinary action when there is credible evidence supporting an allegation of misconduct and/or unethical behavior. A member who is found to have violated the ethical standards will incur a penalty, which, depending on the severity, may include expulsion from the society.
ASE’s Core Values
- Professionalism
- Advancing Knowledge
- Ethical Behavior
- Diversity
- Excellence
- Caring Community
General Reference:
Benjamin IJ, Valentine CM, et al. 2020 American Heart Association and American College of Cardiology Consensus Conference on Professionalism and Ethics. Circulation. 2021;143:e1035–e1087. DOI: 10.1161/CIR.0000000000000963
Core Principles
ASE members are responsible for assisting in achievement of the society’s strategic goals and contributing to the ethical success of the organization. Members also advocate for the ASE by engaging in activities that enhance the society’s credibility and values. Additionally, members are expected to exhibit leadership and serve as role models by maintaining the highest standards of professionalism and ethical conduct.
The strength of the ASE lies in its diversity. Members from various backgrounds bring unique values to the organization and embodies its mission. As ASE professionals, we are ethically responsible for promoting and fostering diversity, fairness, and justice for all members and their organizations. ASE members must maintain a high level of professional integrity regarding trust with patients, the public, other ASE members, and other stakeholders. Engagement in activities that create actual, apparent, or potential conflicts of interest can erode trust and compromise integrity. While it is understood that ASE professionals have a variety of interests and relationships, they should actively seek to disclose, manage, and resolve conflicts of interest.
Intent
ASE members should build respect, credibility, and strategic importance for the profession within our organizations and the business community, and as representatives to the medical community and our patients. Members are responsible to consider and protect the rights of individuals, especially in the acquisition and dissemination of information, while ensuring truthful communications and facilitating informed decision-making. A continuum of achievement must be sustained in both maintaining and building upon competency in personal practice, as well as the education of current and future practitioners, the organizations we serve, and the public.
The organization progresses when individuals of different backgrounds bring unique skillsets, ideas, and values. Therefore, ASE intends to create, sustain, and promote an environment that encourages all individuals and the organization to reach their fullest potential in a unifying and productive manner.
ASE members should appropriately manage activities that are in conflict or may appear to conflict with any of the interests inherent in the provisions of this Code of Ethics or with one’s responsibilities and duties as an ASE member.
1. PROFESSIONALISM
1.1. Strive to achieve the highest levels of patient care, clinical competency, advocacy, and social responsibility.
1.2. Be honest in all professional interactions.
1.3. Report healthcare professionals whose competence or professional conduct which could adversely affect the health or welfare of patients to the appropriate legal, regulatory, and/or
peer-based entity.
1.4. Pursue and maintain appropriate certification, licensure, and compliance with regulations of their licensing, certification, or credentialing body.
1.5. Accurately represent individual experience, education, certification, credentialing, or licensing, and practice cardiovascular imaging only within that scope.
1.6. Adhere to complete, accurate, and competent exams and reporting in the performance of clinical echocardiography, including clinical coding and billing practices.
1.7. Commit to lifelong learning and maintenance of clinical skills and knowledge necessary for the delivery of quality care.
1.8. Actively participate in organizational quality improvement in imaging using consistent application of guidelines-based practice in both personal practice and peer-to-peer training.
1.9. Provide factual testimony when serving as an expert witness that, to the best of their knowledge, is clinically accurate, impartial, and complete.
2. THE AMERICAN SOCIETY OF ECHOCARDIOGRAPHY
2.1. Comply with ASE’s Code of Ethics and adhere to the values of the Society in all interactions related to the organization.
2.2. Honor all fiduciary, legal, and professional obligations in serving the ASE mission, while striving to act in the organization’s best interest.
2.3. Act fairly, respectfully, in good faith, and with honesty in all dealings with ASE staff, fellow members, and other healthcare professionals.
2.4. Endeavor to base opinions on objective data and avoid personal bias when serving on behalf of the ASE, ASEF, ASE Leadership Academy, or in any other professional capacity, including committees, as a board member, a Fellow of the ASE, etc.
3. COMMUNICATION
3.1. Provide accurate and truthful information, act with collegiality, avoid anonymity, declare conflicts of interest, and maintain clear delineation between personal and professional
statements and opinions.
3.2. Ensure disseminated content is unbiased and developed using the best available science and evidence.
3.3. Maintain appropriate boundaries of the provider-patient relationship in all forms of communication and in accordance with professional ethical guidelines.
3.4. Communicate in a manner consistent with the norms and obligations of the profession and in alignment with the ASE’s mission and values when in the public arena (including social media)
and clarify whether they are acting personally or in their ASE role.
3.5. Maintain the trust and confidence of patients by adhering to appropriate confidentiality safeguards regarding disclosure of patient images and information. This commitment extends to education, use of electronic information systems for compiling patient data, and use of social media platforms.
3.6. Notify and/or report any content posted by colleagues that appears unprofessional. Bring the content to the attention of the individual, so that they can remove it and/or take other
appropriate actions. If the behavior significantly violates professional norms and the individual does not take appropriate action to resolve the situation, the member should report the matter
to appropriate authorities.
3.7. Respect intellectual property and copyright laws when posting on social media. Members should follow standard procedures for obtaining permission for reproduction of artwork,
images, the ASE logo and so on, as with any other publication modality.
4. RESEARCH
4.1. Behave ethically and keep the interest of the subject paramount when conducting research and investigation involving human or animal subjects.
4.2. Ensure appropriate protections are in place when involved in human subject research, including institutional IRB review, clear and documented informed consent, continuous data safety
monitoring, confidentially of research subject data, and adherence to institutional, local, state, and national laws, policies, and guidelines.
4.3. Adhere to practices that ensure objectivity, clarity, and reproducibility of the data. Scientific and scholarly activities should include procedures to prevent bias, fabrication, falsification,
plagiarism, outside interference, censorship, and inadequate procedural and information security.
4.4. Agree to peer review as a long-established mechanism to scrutinize professional conduct, promote professionalism, and maintain trust.
4.5. Ensure the review, reporting, and communication of research is done in a transparent, fair, full, and unbiased manner.
4.6. Commit to appropriate inclusion of underrepresented populations by enrolling participants who reflect the characteristics of clinically relevant populations regarding age, sex, race, and
ethnicity.
4.7. Fulfill a duty to uphold scientific standards, to promote research, and to create new knowledge [including the development of artificial intelligence (AI)] and ensure its appropriate use. The
society and its members are responsible for the integrity of this knowledge, which is based on sound scientific evidence and physician experience.
4.8. Ensure allegations of scientific misconduct are addressed when carrying out oversight responsibilities in biomedical or health research, through a process that values accountability, timeliness, and fairness
5. DIVERSITY, JUSTICE, AND SOCIAL CONDUCT
5.1. Model professional conduct and cultivate a respectful and inclusive work environment.
5.2. Respect the uniqueness and intrinsic worth of every individual.
5.3. Respect a patient’s autonomy, dignity, and rights.
5.4. Adhere to the ASE value of promoting equity (not just equality).
5.5. Treat people with dignity, respect, and compassion to foster a society free of harassment, intimidation, and discrimination whether based on race, gender, socioeconomic status, ethnicity, religion, or any other social category.
5.6. Support efforts to eliminate healthcare disparities.
5.7. Refrain from any activities, including social media, that incite or promote discrimination, racism, hate crimes, harassment, or other forms of social injustice.
6. CONFLICT OF INTEREST
6.1. Adhere to and advocate for the use of conflict of interest policies.
6.2. Refrain from using ASE position(s) for personal material or financial or other gain, or the appearance of such. This gain applies not only to the individual but also the individual’s family members and close associates.
6.3. Refrain from using ASE position(s) in a manner that conflicts with the mission, values, and goals of the ASE.
6.4. Refrain from jeopardizing patient care for material, financial, or other gain.
6.5. Refrain from jeopardizing research integrity for material, financial, or other gain.
6.6. Refrain from jeopardizing educational integrity for material, financial, or other gain.
6.7. Disclose conflicts of interest as required for participation in ASE activities to relevant parties and agree to management plans that address the conflicts of interest, in accordance with the ASE volunteer COI disclosure policy (https://www.asecho.org/officersandboardnominations/conflict-of-interest/).
CONFLICT OF INTEREST SUPPLEMENTAL MATERIALS
Relations with industry or commercial entities present one of the most visible and traceable conflicts of interest, but there are other instances in which valued interests can be compromised, including conflicts involving appointments/positions, roles in other professional organizations, publications, noncommercial research funding, and charitable contributions (see table below). Open Payments is a federal system that requires companies to report “transfers of value” to healthcare institutions and clinicians (https://www.cms.gov/openpayments). These transfers are publicly reported on an easily searchable website. Although sometimes inaccurate, Open Payments reports can be used by anyone to compare ASE members’ stated industry/commercial disclosures with those in the report. Not all relationships and transfers of value conflict with primary interests, but they may appear to do so, and even these instances of apparent conflicts of interest may require management. Management may take the forms of disclosure, limitation, and/or withdrawal/divestiture.
- Disclosure involves reporting of all conflicts of interest and potentially perceived conflicts of interest. Therefore, erring on the side of broad and complete disclosure is the best practice.
- Limitation may involve restricting participation in activities that involve a conflict of interest, such as recusal from discussion or voting.
- Withdrawal/divestiture refers to ending participation in a conflicting, secondary interest, relationship or position or giving up conflicting financial or other gains.
